A diabetes disease management program conducted by the American
Pharmacists Association Foundation is being made available to employers
nationwide as a result of a series of successful tests.
The program, the Diabetes Ten City Challenge, has yielded substantial savings
for employers even after they’ve waived co-payments for participants and paid
for individual counseling. Patients also saved money and improved in several key
clinical areas associated with the condition, officials said.
Results of the Diabetes Ten City Challenge, which will be published in a
peer-reviewed article in the May/June issue of the Journal of the American
Pharmacists Association, show average reductions in per-patient health care
costs of $1,079 a year. Aggregate data for 573 participants, who were in the
program an average of 14.8 months, showed they saved an average of $593 per year
on their diabetes medication and supplies.
The data also identified improvements in blood glucose, cholesterol and blood
pressure levels, all of which usually are elevated in diabetes patients.
Moreover, the analysis found increases in usage of preventive care, such as flu
vaccinations as well as eye and foot exams.
The program is based on the Asheville Project model, in which employers waive
co-payments and deductibles for prescription drugs and related monitoring
devices, such as glucose meters, for plan members who agree to receive periodic
counseling from pharmacists. In addition, the employer pays an hourly fee to the
pharmacists.
While the Asheville Project, first implemented in 1997, involved just
employees and dependents of the North Carolina city and Mission Health &
Hospitals, the region’s largest health care provider, the DTCC included 30
employers in 10 cities across the United States.
The same process of care used in the Asheville Project and the DTCC will be
made available to employers nationwide through HealthMapRx, a Reston,
Virginia-based partnership between the APhA Foundation and Mirixa Corp., said
Bud Meadows, senior vice president of sales and development at Mirixa. The
National Community Pharmacists Association sponsors Mirixa.
Using its technology, Mirixa will use claims data from employers’ third-party
administrators or insurers to identify prospective patients and then monitor
interventions provided and patients’ progress. The program also will match
patients with community pharmacist coaches.
Meadows estimated the program will cost employers “only a couple of hundred
dollars annually” in addition to counseling fees, which average about $400
annually per person.
But the return on investment is quick and builds over time, Meadows said.
“We’ve had some clients who have been in the program for three or four years,
and we see the savings continue to improve because the patients better manage
their condition and their medical expenses go down,” Meadows said.
In the first five years after implementation, for example, the city of
Asheville and Mission Health saw the average cost of care for their diabetic
plan members fall an average of $2,000 per patient per year, growing to nearly
$3,000 per patient in the sixth year of the program.
“The second thing is … self-insured employers … are seeing reductions in
their reinsurance premiums,” Meadows said.
Although the program has consistently yielded savings for employers, some
health benefits experts expressed concern that economic conditions could deter
some employers from adopting it.
“I do worry about the timing about getting some commitments in the current
economic environment,” said Andrew Webber, president of the National Business
Coalition on Health in Washington, whose members were among participants in the
DTCC. “That’s what we’re hearing from our coalitions and the individual
employers that we talk to.”
However, he said he hoped some employers consider adopting the program
because of the short time frame in which it produced health care cost
savings.
“Usually it takes longer” for a typical disease management program to produce
savings, Webber said. “It’s a very good sign that this program is showing and
demonstrating some gain in a short period of time.”
At least one of the DTCC participants has decided to continue the program
despite its cost: Pactiv Corp., a Lake Forest, Illinois-based food and
food-service packaging company.
“Pactiv results from 2007-08 in the Diabetes Ten City Challenge have been
positive,” a company spokeswoman said. “Pactiv participants are still engaged in
this program and, as a group, are achieving the clinical outcomes as recommended
by the American Diabetes Association. In addition, preliminary data analysis of
the group shows a reduction in the overall health care costs for the group.”
Filed by Joanne Wojcik of
Business
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